Vincristine was studied in a series of dose levels in 392 patients with advanced cancer. It produced tumor regressions in a substantial proportion of patients with advanced lymphosarcoma, reticulum cell sarcoma, Hodgkin's disease, breast cancer, bladder cancer, and carcinomas of unknown primary site. Response occurred about as frequently at 25 μg/kg/week as at higher doses. Maximum response rates occurred in those patients who sustained moderate toxicity as contrasted to those with only mild or no toxic effects or to those with severe manifestations of drug effect on normal tissues. Dose-related sensory, motor, and autonomic neuropathy and central nervous system dysfunctions were observed. Leukopenia and thrombocytopenia were observed. The frequency of responses achieved and their duration were modified by good-or poor-risk status of the patients. Prediction of survival was rather accurate as determined by comparison of prognostication and actual survival times. Responders survived longer than nonresponders. In patients with breast cancer, the survival extension beyond prediction cannot be explained as due solely to vincristine-induced remission time. In some other diseases, therapeutic response to vincristine was able to overbalance a poor prognosis and apparently to increase survival beyond that predicted.
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|Published - Jun 1973